Philadelphia Inquirer

Surprising Medical Bills Will Be Discussed At Hearing

The Philadelphia Inquirer — Thursday, September 9, 2015

By Harold Brubaker, Inquirer Staff Writer

Momentum is building in New Jersey and Pennsylvania to protect consumers against surprise medical bills from out-of-network providers.

NJ for Health Care and Consumer Union on Wednesday released a report in support of a bill that would establish arbitration procedures to deal with out-of-network bills, require audits of health plans to ensure that their networks are adequate, and mandate a database of paid in-network claims to bring transparency to payments by insurers.

"We need to fix this problem and fix it in a way that is fair to all," said Maura Collinsgru, health care program director for New Jersey Citizen Action, an advocacy group.

On Tuesday, Pennsylvania Insurance Commissioner Teresa Miller announced an Oct. 1 hearing on the problem of "balance billing" for out-of-network care.

"The practice of balance billing is particularly troubling when the patient uses a doctor and facility that is in-network according to their health insurance, but is never told that a service they receive is delivered by another provider not in their insurance network," Miller said in a news release.

She said the insurance department had received dozens of complaints in recent years about such bills from ancillary providers.

The hearing will be held from 10 a.m. to 1 p.m. at the State Museum in Harrisburg. The public is invited to testify. Written testimony may be submitted to the department's consumer liaison David Buono, at

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